Liu Shao-hua, Xu Xin-rong, Xu Ji, Zuo Xiang-rong, Qin Ping-ping
The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2003 Jun;15(6):367-9.
To observe the effect of combination of nitric oxide (NO) inhalation and inverse ratio ventilation (IRV) on oxygenation and hemodynamics in endotoxin-induced acute respiratory distress syndrome (ARDS) in sheep.
Sheep ARDS model was induced by an intravenous infusion of low dose endotoxin, and then animals were randomly divided into two groups. (1) NO group (n=6), inhalation of 40x10(-6) nitric oxide. (2) Combination group (n=6), receiving mechanical ventilation with IRV (inspiratory-to-expiratory ratio of 2:1) and inhalation of 40x10(-6) NO. The dynamic changes in gas exchange and hemodynamics were measured with the aid of Swan-Ganz catheter and arterial blood gas analysis before and after the onset of, ARDS and 30 minutes after treatment.
The combination of IRV and 40x10(-6) NO inhalation rapidly reduced mean pulmonary arterial pressure (MPAP), increased PaO(2), decreased P((A-a))O(2), and Qs/Qt without inducing significant change in systemic hemodynamics, and it was a more effective method of correcting hypoxemia than inhalation of nitric oxide alone. NO inhalation did not change the airway pressure of the model, but the combined treatment resulted in reduction of peak inspiratory pressure and increase of mean airway pressure.
The combined use of IRV and NO inhalation has an additive effect on improving oxygenation in endotoxin-induced acute respiratory distress syndrome in sheep.
观察一氧化氮（NO）吸入联合反比通气（IRV）对内毒素诱导的绵羊急性呼吸窘迫综合征（ARDS）氧合及血流动力学的影响。
通过静脉输注低剂量内毒素诱导绵羊ARDS模型，然后将动物随机分为两组。（1）NO组（n = 6），吸入40×10⁻⁶一氧化氮。（2）联合组（n = 6），接受IRV机械通气（吸呼比为2:1）并吸入40×10⁻⁶ NO。在ARDS发作前后及治疗后30分钟，借助Swan - Ganz导管和动脉血气分析测量气体交换和血流动力学的动态变化。
IRV与吸入40×10⁻⁶ NO联合应用可迅速降低平均肺动脉压（MPAP），提高动脉血氧分压（PaO₂），降低肺泡 - 动脉血氧分压差[P(A - a)O₂]和肺内分流率（Qs/Qt），且未引起全身血流动力学的显著变化，是一种比单纯吸入一氧化氮更有效的纠正低氧血症的方法。吸入一氧化氮未改变模型的气道压力，但联合治疗导致吸气峰压降低，平均气道压升高。
IRV与NO吸入联合应用对改善内毒素诱导的绵羊急性呼吸窘迫综合征的氧合具有相加作用。
